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Abstract

Background: Recent research demonstrates the need to consider social and economic factors that are the determinants of diabetes along with individual factors. Although the average crude rate of diabetes in Virginia is 10.9%, some of the census tracts report a much higher rate. Neighborhoods in places like Norfolk, Newport News and Portsmouth in Virginia have a diabetes prevalence rate of around 25%. Using a multilevel approach for diabetes interventions will have a much better outcome as social determinants play a significant role in diabetes-related health disparities.

Method: Diabetes prevalence data in seven cities of Hampton Roads, Virginia was linked to the Health Opportunity Index (HOI) of Virginia, and modeled using multiple regression analysis. HOI provides a composite measure of the social determinants of health – the social, economic, educational, demographic and environmental factors that relate to a community’s well-being.

Results: About 64% of the variability in the crude diabetes prevalence rate could be explained by the model, including years of schooling, income inequality and employment access (p < .001).

Conclusion: Characteristics of neighborhoods, such as education level, income inequality, employment access and available resources provide serious considerations as to why the prevalence rates of diabetes are high in certain areas. Modifying the predictive determinants or removing barriers to access may have an effect on diabetes prevalence.

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